I, the parent/guardian of the child(ren) named below hereby give the permission necessary for my child(ren) to participate in the City of Alexandria summer day camp programs. I understand that my child(ren) will be involved in a wide variety of camp activities and I acknowledge that my child(ren) is capable of participating in these activities.
I agree, individually and on behalf of the minor child(ren), to assume all risks of participating in these programs and activities and do hereby release, hold harmless, and forever discharge the City of Alexandria, its employees, officials and volunteers from any and all causes of actions, claims, costs and demands that I may have individually or on behalf of the minor child(ren), by reason of any harm, accident, injury, or illness arising out of these summer camp activities.
I understand that if my child(ren) has a persistent pattern of negative behavior and interventions have not been successful, I may be asked to voluntarily remove my child(ren) from the program.
Should it be necessary for your child(ren) to have medical treatment while participating in these summer activities, and a parent/guardian cannot be reached, your signature below gives the City of Alexandria personnel permission to use judgment in obtaining medical treatment for your child(ren) and grants medical personnel consent to provide any medical treatment deemed necessary and appropriate. By signing below, you indicate your understanding that the City of Alexandria does not have insurance covering the cost of medical or hospital services for your child(ren) and that any such cost will be your sole responsibility. The City of Alexandria will not administer or supply any medication to your child(ren) at summer day camp.
Summer day camp activities may include off-site field trips. Participation in any such off-site field trip is voluntary, but you must give your child(ren) permission to go. If you do not give permission, your child(ren) will remain at the summer camp site under supervision and will not participate in the field trip. You will be notified in advance of scheduled off-site field trips.
Payments should be made 2 weeks prior to the session. Credit/Debit Cards and Money Orders will be the only form of payment accepted. NO CASH, CHECKS, or MAIL-INS or WILL BE ACCEPTED.
I agree to pay the designated fees in order for my child(ren) to attend summer day camp (including additional fees for late payment and late pick-up.)
Camp Hours are from 7:30 a.m. to 5:30 p.m. Children must be signed out each day from the camp program by a parent or guardian. Due to the number of campers in the program, our 5:30 p.m. closing time will be strictly enforced.
I understand that a $1 per minute fee will occur after 6 P.M. if my child(ren) is not picked up before 5:30 PM.
Make money order payable to:
City of AlexandriaPO Box 71Alexandria, LA 71309
Note: ONLINE PAYMENTS & DROP OFF MONEY ORDERS ACCEPTED.
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